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Report #2868798

Received Oct 27, 2025

Hospitalized
A note on interpretation. VAERS reports are unverified and may be incomplete or coincidental. A report does not establish that a vaccine caused an event, and counts should not be used to calculate incidence or infer causation. Full disclaimer

Overview

Sex
Female
Age
87 yrs
State
MT
Recovered
Not recovered
Vaccinated
Oct 15, 2025
Onset
Oct 15, 2025
Days to onset
0
Hospital days
12

Vaccines (3)

TypeNameManufacturerDoseLotRoute / Site
COVID19COVID19 (COVID19 (MODERNA))MODERNA13052549IM / LA
FLU3INFLUENZA (SEASONAL) (FLUAD)SEQIRUS, INC.1407981IM / RA
TDAPTDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS14YA34IM / LA

Symptoms (2)

Diffusion-weighted brain MRI abnormalEmbolic stroke

Symptom narrative

Patient had a cardioembolic stroke within 1 hour of receiving these vaccines. Was Admitted to Hospital in (withheld city, state) on 10/15/25 and was transferred to (withheld name) Hospital in (withheld city, state) 10/27/2025 for new areas of infarct on DWI. I do not have access to medical records in Hospital (name withheld) at this time.

Current illness

none

Medical history

Hypertension, Hypocholesteremia

Other medications

Aspirin, Rosuvastatin, Lisinopril, Loratadine, Vit C, Vit D, Omega 3, Unisom

Allergies

Tetracycline, Benadryl, egg protein, cat dander